Revision connectors, systems, and methods thereof

ABSTRACT

Connector assemblies, systems, and methods thereof. A connector having body having a first end and a second end; a first connecting member at the first end, the first connecting member having a rod supporting member extending away from the first connector and a passage extending between the first connecting member and the rod supporting member; and a rod extending from the second end. The body and the passage extend co-axially, and a space is provided between the first end and the second end, the space being sized such that a spinal implant screw head is insertable in the space.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.15/083,467 filed Mar. 29, 2016, which is incorporated by referenceherein in its entirety for all purposes.

BACKGROUND Field of the Invention

The present invention relates to rod connectors, such as spinal hardwareconnectors.

Description of the Related Art

At times, spinal surgeons are forced to add additional fixation tospinal segments adjacent to previously instrumented levels. In thesecases, the hardware from the initial surgery interferes with placementof new fixation for the adjacent level. Therefore, there is a need forconnector implants that attach to the existing spinal fusion constructon one end and extend fixation to adjacent levels in need of fusion.Quicker recovery times and lessened discomfort makes minimally invasivesurgical (MIS) techniques favorable in these situations.

SUMMARY

This Summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This Summary is not intended to identify key features oressential features of the claimed subject matter, nor is it intended tobe used to limit the scope of the claimed subject matter.

The present disclosure relates to components, systems, and methods forconnecting one device to another device. For example, one elongateimplant, such as a first rod, may be coupled to another elongateimplant, such as a second rod. The elongate implants, such as rods, arewell known to connect adjacent vertebrae in a spinal fusion procedure.Depending on the configuration of rods or implants, it may be desirableto have one rod connected to another rod or additional implant. In thecase of two or more rods, these rods may be interconnected with one ormore connectors, for example, in a single given surgery, such as ascoliosis operation, or at a later surgery, for example, in a revisionsurgery. In a revision surgery, connectors can be used to connect newfixation constructs to existing fixation constructs without the need toremove the original hardware. The different connection modes provided inthe following exemplary embodiments offer a range of options to bechosen based on a specific clinical scenario and/or surgeon preference.Although certain configurations are shown herein, it is envisioned thatany suitable number, type, and selection of connectors and implants maybe chosen and configured by the skilled surgeon.

According to one embodiment, an articulating revision connector assemblymay include a connector that is configured to connect a new construct toan existing construct in a patient.

In one embodiment, the articulating revision connector assemblycomprises a rod and a connector attached to the rod. The connectorincludes an open clamp portion having a securing mechanism rotatablyconnected thereto and a closed clamp portion rotatably connected to theopen clamp portion. The closed clamp portion has a passage extendingtherethrough. The passage is sized to allow passage of the rodtherethrough. A locking mechanism is configured to releasably preventrotation of the closed clamp portion relative to the open clamp portionwhen the rod is inserted into the passage.

In an alternative embodiment, the articulating revision connectorassembly comprises a rod and a connector releasably connected to therod. The connector includes a first connecting portion extending along alongitudinal axis. The first connecting portion has a first end havingan open connection adapted to releasably retain the rod and a second endhaving a blind passage extending along the longitudinal axis. A secondconnecting portion is rotatably connected to the second end of the firstconnecting portion. The second connecting portion has an axial passageextending generally orthogonal to the longitudinal axis.

In still another alternative embodiment, a method of adding a newconstruct to an existing construct comprises the steps of: providing aconnector having a first connecting portion with an open connection anda second connecting portion rotatably connected to the first connectingportion, the second connecting portion having an axial passage extendingtherethrough; inserting the open connection over a first rod in theexisting construct; securing the first connecting portion to the firstrod; inserting a second rod through the axial passage; rotating thesecond connecting portion relative to the first connecting portion to adesired location; and securing the second rod to the second connectingportion, thereby restricting rotation of the second connecting portionwith respect to the first connecting portion.

In yet another exemplary embodiment, a spinal revision connectorassembly comprises a body having a first end and a second end, a firstconnecting member at the first end, and a rod extending from the secondend.

Another exemplary embodiment of a spinal revision connector assemblycomprises an elongate rod having a first end and a second end, a taperedtip at the first end, and a securing structure at the second end.

In still another exemplary embodiment, the spinal revision connectorassembly comprises a rod and a connector portion attached to an end ofthe rod. The connector portion has a space sized to allow the passage ofa construct therethrough and a connector distal from the rod.

BRIEF DESCRIPTION OF THE DRAWINGS

Other aspects, features, and advantages of the present invention willbecome more fully apparent from the following detailed description, theappended claims, and the accompanying drawings in which like referencenumerals identify similar or identical elements.

FIG. 1 is a side elevational view of an articulating revision connectoraccording to a first exemplary embodiment;

FIG. 2 is a perspective view of the articulating revision connectorshown in FIG. 1 connected to an existing rod construct;

FIG. 3 is a perspective view of the articulating revision connector androd construct shown in FIG. 2, with the connector also being connectedto a newly installed rod;

FIG. 4A-E are end elevational views of the connector shown in FIG. 1,with the articulating portion rotated about multiple angles with respectto the fixed portion of the connector;

FIG. 5 is a sectional view of the articulating revision connector shownin FIG. 1;

FIG. 6 is a side elevational view of an articulating revision connectoraccording to a second exemplary embodiment;

FIG. 7 is a perspective view of an articulating revision connectoraccording to a third exemplary embodiment;

FIG. 8 is a perspective view of the connector shown in FIG. 7 connectedto an existing rod construct and a newly installed rod;

FIG. 9 is a perspective view of an articulating revision connectoraccording to a fourth exemplary embodiment;

FIG. 10 is a perspective view of the connector shown in FIG. 9,connected to an existing rod construct and a newly installed rod;

FIG. 11 is a perspective view of an articulating revision connectoraccording to a fifth exemplary embodiment;

FIG. 12 is a perspective view of an integrated revision connectoraccording to a sixth exemplary embodiment;

FIG. 13 is a perspective view of an integrated revision connectoraccording to a seventh exemplary embodiment;

FIG. 14 is a perspective view of the integrated revision connector shownin FIG. 13, connected to an existing construct;

FIG. 15 is a side elevational view of the integrated revision connectorconnected to an existing construct shown in FIG. 14

FIG. 16 is a perspective view of the integrated revision connector shownin FIG. 13, alternatively connected to an existing construct;

FIG. 17 is a perspective view of an integrated revision connectoraccording to an eighth exemplary embodiment;

FIG. 18 is a perspective view of the integrated revision connector shownin FIG. 17, connected to an existing construct;

FIG. 19 is a perspective view of an integrated revision connectoraccording to a ninth exemplary embodiment, connected to an existingconstruct;

FIG. 20 is a perspective view of an integrated revision connectoraccording to a tenth exemplary embodiment;

FIG. 21 is a perspective view of the integrated revision connector shownin FIG. 20, connected to an existing construct;

FIG. 22 is a perspective view of the integrated revision connector shownin FIG. 20, alternatively connected to an existing construct;

FIG. 23 is a perspective view of an integrated revision connectoraccording to an eleventh exemplary embodiment;

FIGS. 24A-D are side elevational views of advancing stages of aconnecting mechanism of the integrated revision connector shown in FIG.23;

FIG. 25 is a sectional view of the connecting mechanism of theintegrated revision connector shown in FIG. 23;

FIG. 26 is a sectional view of the connecting mechanism of theintegrated revision connector shown in FIG. 23, connected to an existingconstruct;

FIG. 27 is a perspective view of the integrated revision connector shownin FIG. 23, connected to the existing construct;

FIG. 28 is a perspective view of a link connector according to a twelfthexemplary embodiment;

FIG. 29 is a side elevational view of the link connector shown in FIG.28, connected to adjacent screws;

FIG. 30 is a perspective view of a lateral connector according to athirteenth exemplary embodiment;

FIG. 31 is a perspective view of a top loading connector according to afourteenth exemplary embodiment;

FIG. 32 is a perspective view of the link connector shown in FIG. 28 andthe lateral connector shown in FIG. 30, connected to an existingconstruct and supporting a new construct;

FIG. 33 is a perspective view of a lateral offset link connectoraccording to a fifteenth exemplary embodiment;

FIG. 34 is a perspective view of the lateral offset length connectorshown in FIG. 33 and the lateral connector shown in FIG. 30, connectedto an existing construct and supporting a new construct;

FIG. 35 is a perspective view of a sagittal offset link connectoraccording to a sixteenth exemplary embodiment;

FIG. 36 is a side elevational view of the sagittal offset connectorshown in FIG. 35, and the lateral connector shown in FIG. 30, connectedto an existing construct and supporting a new construct;

FIG. 37 is a perspective view of a revision connector according to aseventeenth exemplary embodiment;

FIG. 38 is a side elevational view of the revision connector shown inFIG. 37;

FIG. 39 is a front elevational view of the revision connector shown inFIG. 37;

FIG. 40 is a side elevational view of the revision connector shown inFIG. 37, mounted on an existing construct;

FIG. 41 is a sectional view of the revision connector and existingconstruct shown in FIG. 40;

FIG. 42 is a sectional view of a revision connector according to aneighteenth exemplary embodiment, mounted on an existing construct;

FIG. 43 is a side elevational view of the revision connector shown inFIG. 42, connecting a new construct to the existing construct;

FIG. 44 is a perspective view of a revision connector according to anineteenth exemplary embodiment;

FIG. 45 is a sectional view of the revision connector shown in FIG. 44,mounted on an existing construct;

FIG. 46 is a side elevational view of the revision connector shown inFIG. 45, connecting a new construct to the existing construct;

FIG. 47 is a perspective view of a revision connector according to atwentieth exemplary embodiment;

FIG. 48 is a sectional view of the revision connector shown in FIG. 47,with a set screw, mounted on existing construct;

FIG. 49 is a sectional view of the revision connector shown in FIG. 47,with a wedge, mounted on existing construct;

FIG. 50 is a side elevational view of the revision connector shown inFIG. 47, connecting a new construct to the existing construct;

FIG. 51 is a sectional view of the lateral connector shown in FIG. 30,mounted on an existing construct;

FIG. 52 is a perspective view of a new construct mounted on the lateralconnector shown in FIG. 30;

FIG. 53 is a perspective view of the lateral connector shown in FIG. 30,connecting the new construct to the existing construct;

FIG. 54 is a top plan view of the lateral connector shown in FIG. 30,connecting the new construct to the existing construct;

FIG. 55 is a perspective view of the top loading connector shown in FIG.31, mounted on an existing construct;

FIG. 56 is a perspective view of the top loading connector shown in FIG.31, connecting a new construct to the existing construct;

FIG. 57 is a side elevational view of the top loading connector shown inFIG. 31, connecting the new construct to the existing construct;

FIG. 58 is a perspective view of an offset revision rod according to atwenty-first exemplary embodiment;

FIG. 59 is a top plan view of the offset revision rod shown in FIG. 58;

FIG. 60 is a side elevational view of a distraction/compression clampaccording to a twenty-second exemplary embodiment;

FIG. 61 is a perspective view of the distraction/compression clamp shownin FIG. 60, connected to existing construct;

FIG. 62 is a side perspective view of a double head lateral connectoraccording to a twenty-third exemplary embodiment;

FIG. 63 is a side elevational view of the double head lateral connectorshown in FIG. 62;

FIG. 64 is a top perspective view of the double head lateral connectorshown in FIG. 62;

FIG. 65 is a perspective view of a double head in-line connectoraccording to a twenty-fourth exemplary embodiment;

FIG. 66 is a perspective view of a J-hook connector according to atwenty-fifth exemplary embodiment;

FIG. 67 is a perspective view of a modular head open lateral connectorwith connected rods according to a twenty-sixth exemplary embodiment;

FIG. 68 is a side elevational view modular open head lateral connectorwith connected rods shown in FIG. 67;

FIG. 69 is a perspective view of a single head open lateral connectoraccording to a twenty-seventh exemplary embodiment;

FIG. 70 is a perspective view of a double modular lateral connectoraccording to a twenty-eighth exemplary embodiment;

FIG. 71 is a side elevational view of a Z-rod according to atwenty-ninth exemplary embodiment; and

FIG. 72 is a perspective view of an in-line connector with integratedrod according to a thirtieth exemplary embodiment.

DETAILED DESCRIPTION

In the drawings, like numerals indicate like elements throughout.Certain terminology is used herein for convenience only and is not to betaken as a limitation on the present invention. The terminology includesthe words specifically mentioned, derivatives thereof and words ofsimilar import. The embodiments illustrated below are not intended to beexhaustive or to limit the invention to the precise form disclosed.These embodiments are chosen and described to best explain the principleof the invention and its application and practical use and to enableothers skilled in the art to best utilize the invention.

Reference herein to “one embodiment” or “an embodiment” means that aparticular feature, structure, or characteristic described in connectionwith the embodiment can be included in at least one embodiment of theinvention. The appearances of the phrase “in one embodiment” in variousplaces in the specification are not necessarily all referring to thesame embodiment, nor are separate or alternative embodiments necessarilymutually exclusive of other embodiments. The same applies to the term“implementation.”

As used in this application, the word “exemplary” is used herein to meanserving as an example, instance, or illustration. Any aspect or designdescribed herein as “exemplary” is not necessarily to be construed aspreferred or advantageous over other aspects or designs. Rather, use ofthe word exemplary is intended to present concepts in a concretefashion.

Additionally, the term “or” is intended to mean an inclusive “or” ratherthan an exclusive “or”. That is, unless specified otherwise, or clearfrom context, “X employs A or B” is intended to mean any of the naturalinclusive permutations. That is, if X employs A; X employs B; or Xemploys both A and B, then “X employs A or B” is satisfied under any ofthe foregoing instances. In addition, the articles “a” and “an” as usedin this application and the appended claims should generally beconstrued to mean “one or more” unless specified otherwise or clear fromcontext to be directed to a singular form.

Unless explicitly stated otherwise, each numerical value and rangeshould be interpreted as being approximate as if the word “about” or“approximately” preceded the value of the value or range.

The use of figure numbers and/or figure reference labels in the claimsis intended to identify one or more possible embodiments of the claimedsubject matter in order to facilitate the interpretation of the claims.Such use is not to be construed as necessarily limiting the scope ofthose claims to the embodiments shown in the corresponding figures.

It should be understood that the steps of the exemplary methods setforth herein are not necessarily required to be performed in the orderdescribed, and the order of the steps of such methods should beunderstood to be merely exemplary. Likewise, additional steps may beincluded in such methods, and certain steps may be omitted or combined,in methods consistent with various embodiments of the present invention.

Although the elements in the following method claims, if any, arerecited in a particular sequence with corresponding labeling, unless theclaim recitations otherwise imply a particular sequence for implementingsome or all of those elements, those elements are not necessarilyintended to be limited to being implemented in that particular sequence.

Also for purposes of this description, the terms “couple,” “coupling,”“coupled,” “connect,” “connecting,” or “connected” refer to any mannerknown in the art or later developed of joining or connecting two or moreelements directly or indirectly to one another, and the interposition ofone or more additional elements is contemplated, although not required.Conversely, the terms “directly coupled,” “directly connected,” etc.,imply the absence of such additional elements.

The present disclosure relates to components, systems, and methods forconnecting one elongate implant, such as a first rod, to anotherelongate implant, such as a second rod. The elongate implants, such asrods, are well known to connect adjacent vertebrae in a spinal fusionprocedure. Depending on the configuration of rods or implants, it may bedesirable to have one rod connected to another rod or additionalimplant. In the case of two or more rods, these rods may beinterconnected with one or more connectors, for example, in a singlegiven surgery, such as a scoliosis operation, or at a later surgery, forexample, in a revision surgery.

For example, connectors can be used to connect new fixation constructsto existing fixation constructs without the need to remove index surgeryhardware. A benefit to such direct attachment to existing constructssaves operating time, causes less disruption to the patient, andminimizes patient healing time. The ability of the inventive connectorsto maintain connection with existing constructs can maximize utility incases of varying patient anatomy and existing spinal constructs. Thedifferent connection modes provided in the following exemplaryembodiments offer a range of options to be chosen based on a specificclinical scenario and/or surgeon preference. Thus, although certainconfigurations are shown herein, it is envisioned that any suitablenumber, type, and selection of connectors and implants, such as rods,may be chosen and configured by the skilled surgeon.

While the different connection modes disclosed herein can be usedindependently, those skilled in the art will recognize that theconnection modes can be combined “á la carte” according to patientneeds. Further, while the connection modes disclosed herein can beprovided separately, kits that include various and multiple combinationsof different connection modes can also be provided.

Referring to FIGS. 1-5, an articulating revision connector assembly 100(“connector assembly 100”) according to a first exemplary embodiment isshown. Connector assembly 100 is used to attach to a first rod 50 thatis already present in an existing construct. As shown in FIG. 2, firstrod 50 can be supported by and secured to one or more screw heads 60(e.g., a tulip assembly connected to a polyaxial pedicle screw).Although not shown, a cap or securing member, such as a threaded cap,may then be engaged with the threaded portion of the tulip to secure therod 50 therein. While FIG. 2 shows connector assembly 100 as beinglocated between screw heads 60, those skilled in the art will recognizethat connector assembly 100 can be located in other places along firstrod 50. For example, the connector assembly 100 can positioned such thatit is substantially in contact with a portion of the screw heads 60(e.g. substantially in contact with an outer portion of the tulipassembly).

Referring back FIG. 1, connector assembly 100 is an open lateralconnector that extends an existing construct an adjacent level.Connector assembly 100 includes an open clamp portion 110 rotatablyconnected to a closed clamp portion 130 that provides articulation aboutopen clamp portion 110 to a desired angle. Once the desired rotationalposition is achieved, closed clamp portion 130 can be secured to openclamp portion 110, locking the articulation.

Open clamp portion 110 includes a securing mechanism 112, such as a setscrew, that is rotatably connected thereto. Open clamp portion 110includes a blind passage 114 with a clamp opening 116 that extends alonga first axis “A1”. Securing mechanism 112 is mounted in a throughpassage 118 (shown in FIG. 5) extending generally orthogonally relativeto first axis A1.

Closed clamp portion 130 is rotatably connected to open clamp portion110. Closed clamp portion 130 has a passage 132 extending therethroughthat is sized to allow passage of a second rod 70 (shown in FIG. 3)therethrough. The passage 132 is preferably sized and shaped to receivethe rod 70. In the embodiment shown, the passage 132 is elongated tohave a length greater than its width to allow for some translation ofthe rod 70 in the passage 132 before the securing member 134 istightened. It is envisioned, however, that the passage 132 may besubstantially circular or cylindrical in shape. Rod 70 may be a Z-rod(shown in FIG. 71) in order to extend rod 50 co-linearly, as shown inFIG. 3. Although not shown, any other suitable rod may be selected, forexample, to allow for a parallel configuration or to select a rod thatmay be bent in situ.

Closed clamp portion 130 includes a securing member 134 that is adaptedto bias second rod 70. Securing member 134 is rotatably mounted in athrough-passage 135 that extends generally obliquely relative tolongitudinal axis A1. The rotation of closed clamp portion 130 relativeto open clamp portion 110 is illustrated in FIGS. 4A-4E, which showclosed clamp portion 130 rotated across five different positionsrelative to open clamp portion 110. Those skilled in the art willrecognize that closed clamp 130 has 360° of rotation relative to openclamp portion 110. It is envisioned, however, that the clamp 130 may bepermitted to rotate any suitable amount relative to open clamp portion110.

Referring to FIG. 5, a locking mechanism 150 is configured to releasablyprevent rotation of closed clamp portion 130 relative to open clampportion 110 when rod 70 (not shown in FIG. 5) is inserted into passage132. Locking mechanism 150 includes a blind passage 152 formed in closedclamp portion 130 and extending along longitudinal axis A1. Passage 152has a first set of teeth 154. An insert 156 is longitudinally disposedin passage 152. Insert 156 has a second set of teeth 158 that arereleasably engageable with the first set of teeth 154, such that, wheninsert 156 is longitudinally translated toward open clamp portion 110,second set of teeth 158 engages first set of teeth 154, restrictingrotation of open clamp portion 110 relative to closed clamp portion 130.

Passage 152 has an outwardly flared opening 160, and insert 156 has acorresponding outwardly flared end 162 that is adapted to engageoutwardly flared opening 160 when insert 156 is longitudinallytranslated toward open clamp portion 110. Flared opening 160 of passage152 also includes a lip 164 that extends radially away from first axisA1.

A cap 170 is threadably connected to closed clamp portion 130 torotatably retain closed clamp portion 130 on open clamp portion 110. Cap170 includes a threaded connection 172 that threadably engaged withmating threads 174 on closed clamp portion 130. An exterior of cap 170also includes radially spaced recesses 176 allow for the application ofa tool (not shown), such as, for example, a spanner wrench, toattach/remove cap 170 to/from closed clamp portion 130.

A plurality of bushings and washers 180-184 are located on the exteriorof open clamp portion 110 between cap 170 and lip 164 and serve to forma frictional connection between cap 170 and lip 164 when closed clampportion 130 is locked to open clamp portion 110.

To assemble connector assembly 100 and add rod 70 to an existingconstruct, clamp opening 116 of connector assembly 100 is secured to rod50, and rod 70 is then inserted into passage 132 as shown in theexemplary configuration shown in FIG. 3. When rod 70 is located at adesired angle with respect to rod 50, securing mechanism 112 is advancedthrough passage 118, such that securing mechanism 112 biases rod 70against insert 156, advancing insert 156 along longitudinal axis A1toward passage 114. Teeth 158 on insert 156 engage with teeth 154 inpassage 152 and seat flared end 162 of insert 156 on flared opening 160of passage 152, forcing lip 164 to bias toward cap 170, therebyrestricting rotation of open clamp portion 110 relative to closed clampportion 130.

In an alternative embodiment, shown in FIG. 6, a clamp assembly 200incorporates closed clamp portion 130, but, instead of open clampportion 110, includes an open clamp portion 210 rotatably attachedthereto. Open clamp portion 210 comprises a clamp opening 216 extendingobliquely relative to the first axis A1, with opening 216 in an offsetplane relative to opening 132 in closed clamp portion 130.

In another alternative embodiment of a connector assembly 300, shown inFIG. 7, wherein an open clamp portion 310 comprises a clamp opening 316extending generally orthogonally relative to first axis A1 such that ablind end of opening 316 extends along first axis A1, allowing theinsertion of rod 50 in opening 316 to be coplanar with rod 70 after rod70 is inserted into passage 132. FIG. 8 shows the connection ofconnector assembly 300 with rod 70 extending in the same lateral planeas existing rod 50. This configuration allows the open clamp portion 310to be positioned beneath the existing rod 50. A threaded cap (not shown)may then be engaged with the threaded portion on the top of the openclamp portion 310 to secure the rod 50 therein, thereby coupling rod 50to rod 70.

In still another embodiment of a connector assembly 400, shown in FIGS.9 and 10, an open clamp portion 410 comprises a clamp opening 416extending generally orthogonally relative to first axis A1 such that ablind end of opening 416 extends above first axis A1, allowing theinsertion of rod 50 in opening 416 to be skewed with respect to rod 70after rod 70 is inserted into passage 132. The open clamp portion 410may have a generally U-shaped configuration allowing for the open clampportion 410 to be positioned beneath the existing rod 50. A threaded cap(not shown) may then be engaged with the threaded portion on the top ofthe open clamp portion 410 to secure the rod 50 therein, therebycoupling existing rod 50 to new rod 70.

In yet another embodiment of a connector assembly 500, shown in FIG. 11,and articulating modular lateral head connector is provided. In thisembodiment, the open clamp portion is replaced with a connection point,such as a post, configured to receive a rod having a modular connectionpoint 1220, for example, as depicted in FIG. 28 and described in moredetail below. The post or connection point may have a partiallyspherical outer surface with a generally flat top surface to enableengagement with a corresponding opening in the rod.

Referring now to FIGS. 12-27, a plurality of integrated revisionconnectors according to exemplary embodiments are shown. In an exemplaryembodiment, shown in FIG. 12, a spinal revision connector assembly 600includes a body 610 having a first end 612 and a second end 614. Body610 is generally a closed loop that provides a space sufficiently largefor the insertion of a pre-existing construct, such as, for example, aspinal implant screw head (not shown) therethrough, thereby minimizingthe amount of new construct that is to be connected to an existingconstruct.

A first connecting member 620 is located at first end 612. In anexemplary embodiment, first connecting member 620 can be a threadedopening that allows for the insertion of a fastener, such as a set screw(not shown), that provides for connection to existing construct.

An upper surface 622 of first end 612 includes an arcuate recess 624sized to accept a rod (not shown) from an existing construct. Similarly,a lower surface 626 includes an arcuate recess 628 sized to accept a rod(not shown) from an existing construct. Recesses 624, 626 can be thesame or different sizes (as shown) in order to be able to accommodaterods of different diameters.

A rod 630 extends from second end 614 of body 610. Rod 630 can have atapered tip 632 at a distal end of rod 630 from body 610. Rod 630 canextend an existing construct two adjacent level in order to providerequired fixation.

In an alternative exemplary embodiment, shown in FIGS. 13-16, a spinalrevision connector assembly 700 includes a body 710 having a first end712 and a second end 714. Body 710 is generally an open loop thatprovides a space sufficiently large for the insertion of body 710 overthe top of a screw head 60 in an existing construct where rod 50 is ofinsufficient length protruding from the side of screw head 60, as shownin FIGS. 14 and 15. Alternatively, body 710 can go around screw head 60in the existing construct, as shown in FIG. 16.

A first connecting member 720 is located at first end 712. In anexemplary embodiment, first connecting member 720 can be one or morethreaded openings 722, 724, that allow for the insertion of a fastener,such as a set screw (not shown), that provides for connection toexisting construct. Additionally, a lower lip 726 is used to support anunderside of rod 50 to provide secure clamping of first connectingmember 720 to rod 50, such that a passage 727 is formed between lowerlip 726 and first end 712.

A rod 730 extends from second end 714 of body 710. Rod 730 can have atapered tip 732 at a distal end of rod 730 from body 710. Rod 730extends along a common axis with passage 727 such that rod 730 extendsthe existing construct of rod 50 at an adjacent level.

In another alternative exemplary embodiment, shown in FIGS. 17 and 18, aspinal revision connector assembly 800 includes a body 800 and having afirst end 812 and a second end 814. Body 810 is generally an open loopwith a space between first end 812 and second end 814 that allows forthe insertion of body 810 over the top of screw head 60 in an existingconstruct where rod 50 is of insufficient length protruding from theside of screw head 60, as shown in FIG. 18. It is noted that, in FIG.18, the length of rod 50 extending beyond screw head 60 is longer thanthat shown in FIG. 14, allowing for the use of assembly 800, as shown inFIG. 18.

A first connecting member 820 is located at first end 812 and a secondconnecting member 822 is located at second end 814. First connectingmember 820 and second connecting member 822 can be threaded openingsthat allow for the insertion of a fastener, such as a set screw (notshown), to secure assembly 800 to rod 50 where rod 50 is sufficientlylong to allow rod 50 to extend beyond screw head 60, such that rod 50can be engaged and secured by second connecting member 822, as shown inFIG. 18. Additionally, a first lower lip 824 at first connecting member820 and a second lower lip 826 at second connecting member 822 are usedto support an underside of rod 50 to provide secure clamping ofconnecting members 820, 822 to rod 50, such that a passage 827 is formedbetween first lower lip 824 and first end 812 and between second lowerlip 826 and second end 814.

A rod 830 extends from second end 814 of body 810. Rod 830 can have atapered tip 832 at a distal end of rod 830 from body 810. Rod 830extends along a common axis with passage 827 such that rod 730 extendsthe existing construct of rod 50 at an adjacent level.

In still another alternative exemplary embodiment, shown in FIG. 19, aspinal revision connector assembly 900 includes a body 910 having afirst end 912 and a second end 914. Body 910 is generally a closed loopthat provides a space between first end 912 and second end 914sufficiently large for the insertion of a pre-existing construct, suchas, for example, screw head 60, therethrough, thereby minimizing theamount of new construct that is to be connected to an existingconstruct.

A first connecting member 920 is located at first end 912 and a secondconnecting member 922 is located at second end 914. First connectingmember 920 and second connecting member 922 can be threaded openingsthat allow for the insertion of a fastener, such as a set screw (notshown), to secure assembly 900 to rod 50 where rod 50 is sufficientlylong to allow rod 50 to extend beyond screw head 60, such that rod 50can be engaged and secured by second connecting member 922.

A rod 930 extends from second end 914 of body 910. Rod 930 can have atapered tip 932 at a distal end of rod 930 from body 910.

In still another alternative exemplary embodiment, shown in FIGS. 20-22,a spinal revision connector assembly 1000 includes a body 1010 having afirst end 1012 and a second end 1014. Body 1010 is generally an openloop that provides a space between first end 1012 and second end 1014that is sufficiently large for the insertion of a pre-existingconstruct, such as, for example, screw head 60, therethrough, therebyminimizing the amount of new construct that is to be connected to anexisting construct. FIG. 21 shows body 1010 extending over top of screwhead 60, while FIG. 22 shows body 1010 extending around screw head 60.

A first connecting member 1020 is located at first end 1012. Firstconnecting member 1020 can be a threaded opening that allows for theinsertion of a fastener, such as a set screw (not shown), to secureassembly 1000 to rod 50. Connecting member 1020 also includes clampingsurfaces 1022, 1024 that extend outwardly from first end 1012. Clampingsurfaces 1022, 1024 are spaced sufficiently from each other to allow rod50 to slide therethrough such that, when the fastener or set screw issecured, first connecting member 1020 securely grips rod 50.

A rod 1030 extends from second end 1014 of body 1010. Rod 1030 can havea tapered tip 1032 at a distal end of rod 1030 from body 1010. Rod 1030extends at the adjacent level as for 50 (shown in FIG. 21).

In another alternative exemplary embodiment, shown in FIGS. 23-27, aspinal revision connector assembly 1100 includes a body 1110 having afirst end 1112 and a second end 1114. First end 112 includes a clamphousing that contains an inner revolving mechanism 1116 that can berotated to surround the underside of an existing rod 50.

Mechanism 1116 includes a rotating clamp 1118 that is mounted on a pivot1120. A distal end of clamp 1118 includes a plurality of ratchet teeth1122. When clamp 1118 is rotated from the position shown in FIG. 24A tothe position shown in FIG. 24D, ratchet teeth 1122 engage a securingmechanism in the form of internal ratchet teeth 1124 within body 1110 tosecure clamp 1118 around rod 50, as shown in FIG. 25, preventing clamp1118 from rotating backwards after final tightening. Clamp 1118 isrotated by rotating mechanism 1120. As shown in FIGS. 24A-24D, rotatingmechanism 1120 can be a hex head screw that can be rotated by engaging ahex head tool, such as, for example, an Allen wrench (not shown), withrotating mechanism 1120 and rotating.

Body 1110 includes arcuate cutouts 1126 on opposing sides thereof (onlyone cutout 1126 shown in FIG. 25), that are sized to receive rod 50 sothat body 1110 snugly fits on rod 50. Body 1110 also includes a threadedtop opening 1128 sized to receive a set screw 1129 inserted therein sothat set screw 1129 can be screwed on top of rod 50, as shown in FIG.26.

A rod 1130 extends from second end 1114 of body 1110. Second end 1114comprises an offset portion 1132 and distal end 1134 extending away fromoffset portion 1132, such that distal end 1134 is at an adjacent levelwith rod 50, as shown in FIG. 27. A space is provided between first end1112 and second end 1114 that is sufficiently large for the insertion ofa pre-existing construct, such as, for example, a spinal implant screwhead (not shown) therethrough, thereby minimizing the amount of newconstruct that is to be connected to an existing construct.

Referring now to FIGS. 28-38, a plurality of link connectors accordingto exemplary embodiments are shown. A first exemplary link connector1200 is used with a mating modular connection point on a spinal screw,or a secondary connector implant.

Referring specifically to FIGS. 28 and 29, a connector 1200 includes arod 1210 within modular connection point 1220 at a first end. Connectionpoint 1220 is a generally hollow body. Also, connection point 1220includes a threaded connector, such as, for example, a fastener or setscrew 1222 rotatably connected thereto and extending into the hollowbody of connection point 1220. Additionally, connection point 1220includes a diametrically opposed indents 1224 (only one indent 1224shown in FIG. 28) to accommodate a gripping tool, such as, for example,a spanner wrench (not shown) that can be used to secure rod 1210 at adesired position while set screw 1220 is being tightened.

FIG. 29 shows connector 1200 spanning screw heads 60, 62. Connectionpoint 1220 is secured directly to screw 62, while rod 1210 is secured toscrew head 60, placed at an adjacent level.

Referring to FIG. 30, an exemplary embodiment of a lateral connector1300 is shown. Lateral connector 1300 includes a base 1310 having afirst end 1312 with a connection point 1314 extending upwardlytherefrom. Connection point 1314 is sized to fit into connection point1220 and receives set screw 1222 from link connector 1200.

Base 1310 also has a second end 1320 that includes a rod clamp 1322. Rodclamp 1322 includes an arcuate surface 1324 for engaging a rod and a topsurface 1326, extending above connection point 1314, that supports asecuring member, such as, for example, a set screw 1328 that can berotated to secure rod 50 within rod clamp 1322, as shown in FIG. 32. Asshown in FIG. 32, rod 1210 can extend at an oblique angle relative torod 50, in order to accommodate for the lateral offset in lateralconnector 1300.

Referring to FIG. 31, a top loading connector 1400 is shown. Connector1400 includes a body 1410 that includes a rod clamp 1412. Rod clamp 1412includes an arcuate surface 1414 for engaging a rod and a flat topsurface 1416 disposed above arcuate surface 1414. Top surface 1416includes a first threaded connection 1418 that receives a set screw1420. Top surface 1416 also includes a second threaded connection 1422,for receiving an additional connector (not shown).

Referring now to FIGS. 33 and 34, a lateral offset link connector 1500is shown. Link connector 1500 is similar to link connector 1200, withthe exception that, instead of a straight elongate body 1210, linkconnector 1500 includes a body 1510 having a first end 1512 connected toa modular connection point 1520, similar to modular connection point1220, a second, free end, 1514, and a lateral offset 1516, connectingfirst end 1512 with second end 1514. Lateral offset 1516 is sized toaccommodate the same lateral offset as with lateral connector 1300.

As shown in FIG. 34, modular connection point 1520 can be connected tolateral connector 1300, which in turn is connected to a rod 50 in anexisting construct such that second end 1514 extends generallyco-linearly with rod 50, thereby allowing second end 1514, toeffectively act as an extension of rod 50.

Referring now to FIGS. 35 and 36, a sagittal offset link connector 1600is shown. Link connector 1600 is similar to link connector 1500, withthe exception that, instead of lateral offset 1516, link connector 1600includes a body 1610 having a first end 1612 connected to modularconnection point 1620, similar to modular connection point 1520, asecond, free end, 1614, and a sagittal offset 1616, connecting first end1612 with second end 1614. Sagittal offset 1616 is sized to allowconnector 1600 to extend upward and over a screw head 60 when connectedto a lateral connector 1300 and rod 50, as shown in FIG. 36.

As shown in FIG. 36, modular connection point 1620 can be connected tolateral connector 1300, which in turn is connected to a rod 50 in anexisting construct such that second end 1614 extends generallyco-linearly with rod 50, thereby allowing second end 1514, toeffectively act as an extension of rod 50.

Referring now to FIGS. 37-57, a plurality of link connectors accordingto exemplary embodiments are shown. FIGS. 37-41 show a connector 1700according to an exemplary embodiment. Connector 1700 is connected to anexisting rod by a twisting connection and subsequent to attachment, asecond, new rod may be positioned above and in-line with the existingrod. For example, connector 1700 may be inserted between two existingscrew head 60, proximal to an adjacent level that needs additionalfixation.

Connector 1700 includes a body 1710 having a connecting portion 1712 ata first end and a screw head portion 1720 at an opposing end. Connectingportion 1712 includes a pair of outwardly extending curved legs 1714,1716 that extend downwardly from diametrically opposed sides of body1710 in opposing directions, forming a passage 1718 sized to allow a rod50 to extend therethrough.

Screw head portion 1720 includes a first arcuate portion 1722 and asecond arcuate portion 1724 diametrically opposed from first arcuateportion 1722, forming a rod through-passage 1725 extending therebetween.The interior faces of each of arcuate portion 1722, 1724 are threaded atthreads 1726 to accommodate insertion of a set screw 1730, shown in FIG.41.

To install connector 1700 on a rod 50, connector 1700 is inserted withrod through-hole 1725 facing in a medial/lateral direction and legs1714, 1716 straddling rod 50, as shown in FIG. 40. Connector 1700 isthen rotated 90° in situ, so that rod 50 extends through passage 1718,with legs 1714, 1716 extending underneath rod 50, as shown in FIG. 41.Set screw 1730 is then screwed downward to engage rod 50, securingconnector 1700 to rod 50.

In an alternative embodiment of a connector 1800, shown in FIG. 42,instead of threads 1726 and set screw 1730, lower interior surfaces of afirst arcuate portion 1822 and a second arcuate portion 1824 areunthreaded and a wedge 1826 is advanced through a rod through-passage1825 to engage rod 50 and secure rod 50 to connector 1800.

As shown in FIG. 43, either connector 1700 or connector 1800 can beattached to an existing rod 50 through passage 1718 and a new constructwith a rod 80 can be inserted through rod through-passage 1725, 1825. Athreaded cap (not shown) may then be engaged with the threaded portionon the top of the screw head portion 1720 to secure the rod 80 therein,thereby achieving fixation. If required, rod 80 can be bent to maintainnew construct and an adjacent level with the existing rod 50.

FIGS. 44-46 show a connector 1900 according to an exemplary embodiment.Connector 1900 includes a body 1910 having a connecting portion 1912 ata first end and a head portion 1930 at an opposing end. Connectingportion 1912 includes a first generally longitudinally extending leg1914 having a connection mechanism 1916 extending therethrough. In anexemplary embodiment, connection mechanism 1916 can be a set screw.

Connecting portion 1912 also includes a second leg 1917, having a firstportion 1918 that extends generally longitudinally away from body 1910,generally parallel to first leg 1914. Second leg 1917 also includes acurved portion 1919 that curves an arcuate fashion toward first leg1914, forming a passage 1920 therebetween. Passage 1920 is sized toallow connector 1900 to be connected to an existing rod 50, as shown inFIG. 46. Connection mechanism 1916 extends sufficiently through firstleg 1914 to be able to extend into passage 1920.

Head portion 1930 includes a first arcuate portion 1932 and a secondarcuate portion 1934 diametrically opposed from first arcuate portion1932, forming a rod through-passage 1935 extending therebetween. Rodthrough-passage 1935 is sized to receive a rod 80 as part of a newlyassembled construct, as shown in FIG. 46. If rod 80 is a “Z-Rod”, rod 80can be configured to achieve fixation at an adjacent level with rod 50.

FIGS. 47-50 show a connector 2000 according to an alternative exemplaryembodiment. Connector 2000 is similar to connector 1900 as describedabove, with the exception that connector 2000 includes only a single leg2017 extending downward from a body 2010. Leg 2017 includes a firstportion 2018 that extends longitudinally outwardly, away from body 2010and a curved portion 2019 that curves in an open hook fashion toward anopposing side of body 2010, forming an open passage 2020. Curved portion2019 includes an arcuate support face 2021 faces open passage 2020 andserves as a support for an existing rod 50, as shown in FIG. 50.

FIG. 48 shows connector 2000 with an optional set screw 2030 can bethreaded into a threaded passage 2032 to secure connector 2002 existingconstruct, such as, for example, rod 50.

Alternatively, FIG. 49 shows connector 2000 and optional wedge 2040 thatcan be used in place of set screw 2030, to secure rod 50 in connector2000.

Similarly to connector 1900, connector 2000 has a rod through-passage2035 is sized to receive a rod 80 as part of a newly assembledconstruct, as shown in FIG. 50. If rod 80 is a “Z-Rod”, rod 80 can beconfigured to achieve fixation at an adjacent level with rod 50.

Lateral connector 1300, shown previously in FIG. 30, can be used asshown in FIG. 51 to connect to a rod 50 in an existing construct. Asshown in FIGS. 52-54, new construct 90 can be attached at connectionpoint 1314 to achieve fixation. Instead of installing connector 1200 atan angle, as shown in FIG. 32, FIGS. 53 and 54 show that, when rod 80 isa Z-Rod, lateral connector 1300 can be used to support rod 80 such therod 80 extends collinear with existing rod 50.

Top loading connector 1400, shown previously in FIG. 31, can be used. Asshown in FIGS. 55-57 to connect to an existing rod 50. In an existingconstruct. As shown in FIGS. 56 and 57, new construct 90 can be attachedat connection 1422 to achieve fixation. As will be appreciated by thoseskilled in the art, after the rod 80 is secured and attached to theexisting rod 50 and the adjacent vertebra or vertebrae using a minimallyinvasive surgical (MIS) approach, the extensions may be detached fromthe tulips, thereby leaving the connector 1400 and rod 80 subcutaneouslyimplanted in the patient.

Referring now to FIGS. 58 and 59, an offset revision rod 2100 accordingto an exemplary embodiment is shown. Revision rod 2100 has an elongatebody 2110 having a first end 2112, with an integrated single open clamp2120 extending laterally therefrom. Claim 2120 includes a body 2122 witha clamp portion 2124 sized to accept and retain a rod (not shown)between proximal existing screw heads (also not shown). Body 2122 alsoincludes a threaded opening 2126 sized to accept a fastener, such as aset screw (not shown), that can be screwed downwardly to secure the rodinto clamp portion 2124.

Body 2110 further has a second end 2130 an offset 2132, between firstend 2112 and second and 2130, such that first and 2112 and second end2130 extend parallel to each other. Rod 2100 allows a fixation to beextended to adjacent level with a single implant. Offset 2132 allows rod2100 to navigate around a most proximal screw head (not shown) in anexisting construct.

A distraction/compression clamp 2200 is shown in FIGS. 60-61. Clamp 2200has a single open clamp 2210 with a through passage 2212 sized to accepta rod 50 inserted therethrough. Claim 2200 also includes a threadedopening 2220 that is sized to accept a set screw 2222 to secure clamp2200 to rod 50. Clamp 2200 can provide a fixed point for distractionand/or compression.

A double-headed lateral connector 2300 is shown in FIGS. 62-64.Connector 2300 includes a body 2310 having a first screw head 2320(e.g., a first tulip) having a passage 2322 and a second screw head 2330(e.g., a second tulip) having a passage 2332. Screw heads 2320 and 2330are separated from each other by a connecting member 2340. Passage 2322is sized to accept a first rod (not shown) from an existing constructand passage 2332 is sized to accept a second rod (not shown) from thenew construct in order to extend the existing construct to an adjacentlevel. A threaded cap (not shown) may then be engaged with each of thethreaded portions on the tops of the screw heads 2320 and 2330 to securethe respective rods therein, thereby coupling the rods substantiallyparallel to one another. While FIG. 62 shows screw heads 2320, 2330extending parallel to each other, those skilled in the art willrecognize that screw heads 2320, 2330 can also be offset or angledrelative to each other.

While FIG. 62 shows connecting member 2340 connecting first screw head2320 and second screw head 2330 only at the bottom portion of connector2300, FIGS. 63 and 64 show a connecting member 2350 that connects firstscrew head 2320 and second screw head 2330 along the length of the screwheads.

FIG. 65 shows a double-headed in-line connector 2400 according to anexemplary embodiment. While lateral connector 2300 discussed abovelaterally connects adjacent rods, in-line connector 2400 connectsadjacent rods longitudinally. Connector 2400 includes a body 2410 havinga first screw head 2420 having a passage 2422 and a second screw head2430 having a passage 2432. Screw heads 2420 and 2430 are separated fromeach other by a connecting member 2440. Passage 2422 is sized to accepta rod (not shown) from an existing construct and passage 2432 is sizedto accept a rod (not shown) from the new construct in order to extendexisting construct to an adjacent level. A threaded cap (not shown) maythen be engaged with each of the threaded portions on the tops of thescrew heads 2420 and 2430 to secure the respective rods therein, therebycoupling the rods substantially in-line with one another. While FIG. 65shows screw heads 2420, 2430 extending parallel to each other, thoseskilled in the art will recognize that screw heads 2420, 2430 can alsobe offset or angled relative to each other.

A J-hook connector 2500 according to an exemplary embodiment is shown inFIG. 66. Connector 2500 includes an elongate body 2510 having a firstend 2512 and a second end 2514. First end 2512 includes an open clamp2520 attached thereto. Clamp 2520 includes a passage 2522 sized to allowa rod (not shown) to be inserted therethrough. Clamp 2520 also includesa threaded opening 2524 sized to allow a set screw (not shown) to beinserted therethrough to secure the rod within opening 2524.

Connector 2500 is used to connect a rod (not shown) on a first side of apatient's spine with first end 2512, and to insert second end 2514 intoa screw head (not shown) on an opposing side of the patient's spine.

A parallel connector 2600 according to an exemplary embodiment is shownin FIGS. 67 and 68. Connector 2600 includes a body 2610 having agenerally oblong opening 2612 that is sized to allow the insertion of 2rods 50, 50′ therethrough to extend the length of rod 50, with rod 50′.As shown in FIG. 68, a single set screw 2620 extends through body 2610between rods 50, 50′ to secure rods 50, 50′ to connector 2600. While asingle set screw 2600 is shown, those skilled in the art will recognizethat to set screws, one located above each of rod 50, 50′, can be usedto secure rods 50, 50′, respectively, to connector 2600.

FIG. 69 shows a single open head lateral connector 2700 according to anexemplary embodiment. Connector 2700 includes an open clamp 2710 and anadjacent screw head 2720, coupled to each other by a connector 2730.

Open clamp 2710 includes an arcuate portion 2712, forming athrough-passage 2713 that is sized to accept a rod (not shown) from anexisting construct inserted therein. Open clamp 2710 also includes athreaded opening 2714 sized to accept a set screw (not shown) that canbe threaded into through-passage 2713 to secure the rod inthrough-passage 2713.

Screw head 2720 includes a passage 2722 that is sized to allow theinsertion of a rod (not shown) in new construct therein. Through-passage2713 and passage 2722 extend in a common plane such that the rod in thenew construct is at the same level as the rod in the existing construct.

FIG. 70 shows a double modular lateral connector 2800 according to anexemplary embodiment. Connector 2800 includes an elongate body 2810having a first end 2812 and a second end 2814, distal from first end2812. Each end 2812, 2814 includes a point of attachment 2820, 2822,respectively for the attachment of modular screw heads side-by-side, asshown, allowing for options variety of screw heads. Each point ofattachment 2820, 2822 may be in the form of a post having apartially-spherical outer surface with a substantially flatten topsurface having one or more recesses therein. In one embodiment, a tulipcan be placed on attachment point 2820 before or after connecting to anexisting rod (not shown). The new rod (not shown) can then beintroduced, for example, in a second tulip attached to attachment point2822 in order to extend the fixation at an adjacent level. In thealternative, a rod 1200, for example, shown in FIG. 28, with anintegrated attachment point 1220 can connect to one or more of the postson connector 2800. While connection points 2820 and 2822 are shown asbeing parallel to each other, those skilled in the art will recognizethat connection points 2820, 2822 can also be offset or angled relativeto each other.

FIG. 71 shows a Z-rod 80 according to an exemplary embodiment. As shownpreviously throughout, rod 80 is used to link to an existing constructat an adjacent level. Rod 80 includes a generally elongate body 82having a first end, a second end 86, distal from first end 84, and abent portion 88, located along body 82, between first and 84 and secondend 86. The position and offset distance of bend portion 88 can bevaried depending upon the location of existing construct and theparticular patient anatomy.

FIG. 72 shows an in-line connector with an integrated rod 3000 accordingto an exemplary embodiment. Rod 3000 includes an elongate body 3010having a first end 3012 and a second end 3014, distal from first end3012. A closed connector 3020 is attached to first end 3012. Connector3020 includes an opening 3022, in line with, and, distal from body 3010into which an existing rod (not shown) is inserted to extend the lengthof an existing construct at an adjacent level. Then one or morefasteners or set screws (not shown) may be positioned in the one or moreopenings in the connector portion 3020 to secure the existing rodtherein, thereby coupling the new rod extension to the existing rodconstruct.

The connectors described herein offer versatility in connecting spinalrod implants together. In the case of an existing construct beingaccessed in a revision surgery, the new fixation constructs may beattached without the need to remove the original surgical hardware. Byattaching directly to existing spinal rod constructs saves operatingtime, causes less disruption to the patient, and improves patienthealing times. The connectors maximize utility in cases of varyingpatient anatomy and different configurations for existing constructs.The different connection modes offer a wide range of options forimproved patient outcomes.

It will be further understood that various changes in the details,materials, and arrangements of the parts which have been described andillustrated in order to explain the nature of this invention may be madeby those skilled in the art without departing from the scope of theinvention as expressed in the following claims.

What is claimed is:
 1. A spinal revision connector assembly comprising:a body having a first end and a second end; a first connecting member atthe first end, the first connecting member having a rod supportingmember extending away from the first connecting member and a passageextending through the first connecting member, the first connectingmember comprising a rotating clamp mounted on a pivot located above anexisting rod, wherein the rotating clamp includes an arm extending froma proximal end at the pivot above the existing rod to a distal endspaced apart from a side of the existing rod, and wherein the rotatingclamp is rotatable to surround an underside of the existing rod andcontact the underside to thereby secure the spinal revision connector tothe existing rod; a fastener coupled to the body and positioned tocontact an upper side of the existing rod, the fastener and the rotatingclamp acting together to secure the existing rod to the body; and a rodextending from the rod supporting member, wherein the rod and thepassage extend co-axially, and wherein a space is provided between thefirst end and the second end, the space being sized such that a spinalimplant screw head is insertable in the space.
 2. The spinal revisionconnector assembly according to claim 1, wherein the body comprises aclosed loop.
 3. The spinal revision connector assembly according toclaim 1, wherein the body comprises an open loop.
 4. The spinal revisionconnector assembly according to claim 1, further comprising a secondconnecting member at the second end.
 5. The spinal revision connectorassembly according to claim 1, wherein the rod comprises an offsetportion.
 6. The spinal revision connector assembly according to claim 1,wherein the clamp comprises a ratcheting member at a distal end thereof.7. The spinal revision connector assembly according to claim 1, furthercomprising a securing member adapted to secure the clamp in a lockedposition.
 8. The spinal revision connector assembly according to claim1, wherein the first connecting member is releasably connected to thefirst end of the body.
 9. The spinal revision connector assembly ofclaim 1, wherein the distal end of the rotating clamp comprises aplurality of ratchet teeth configured to engage with a correspondingplurality of internal ratchet teeth formed in the connector portion tosecure the rotating clamp around the existing rod.
 10. A spinal revisionconnector assembly comprising: an elongate rod having a first end and asecond end; a tapered tip at the second end; and a securing structure atthe first end, the securing structure comprising a rotating clampmounted on a pivot located above an existing rod, wherein the rotatingclamp includes an arm extending from a proximal end at the pivot abovethe existing rod to a distal end spaced apart from a side of theexisting rod, and wherein the rotating clamp is rotatable to surround anentire underside of the existing rod and contact the underside; and thesecuring structure including a fastener positioned to contact an upperside of the existing rod, the fastener and the rotating clamp actingtogether to secure the spinal revision connector to the existing rod.11. The spinal revision connector assembly according to claim 10,wherein the securing structure comprises a closed loop and a first clampconnection, distal from the rod.
 12. The spinal revision connectorassembly according to claim 11, wherein the securing structure furthercomprises a second clamp connection, proximate to the rod.
 13. Thespinal revision connector assembly according to claim 10, wherein thesecuring structure comprises an open loop and a first clamp connection,distal from the rod.
 14. The spinal revision connector assemblyaccording to claim 13, wherein the securing structure further comprisesa second clamp connection, proximate to the rod.
 15. The spinal revisionconnector assembly according to claim 10, wherein the rod comprises anoffset portion.
 16. The spinal revision connector assembly according toclaim 10, wherein the securing structure comprises a ratchetingmechanism at a distal end of the rotating clamp.
 17. A spinal revisionconnector assembly comprising: a rod; and a connector portion attachedto an end of the rod, the connector portion having a space sized toallow the passage of a construct therethrough and a connector distalfrom the rod, the connector comprising a rotating clamp mounted on apivot located above an existing rod, wherein the rotating clamp includesan arm extending from a proximal end at the pivot above the existing rodto a distal end spaced apart from a side of the existing rod, andwherein the rotating clamp is rotatable to surround an entire undersideof the existing rod and contact the underside; and the connectorincluding a fastener positioned to contact an upper side of the existingrod, the fastener and the rotating clamp acting together to secure thespinal revision connector to the existing rod.
 18. The spinal revisionconnector assembly according to claim 17, wherein the space is a closedloop.
 19. The spinal revision connector assembly according to claim 17,wherein the space is an open loop.